MIXED BAG Anterior paramedian retroperitoneal Anterior - - PowerPoint PPT Presentation

MIXED BAG

• Anterior paramedian

retroperitoneal

• Anterior transperitoneal
• Flank Incision

Retroperitoneal

• Lateral trans psoas

(XLIF)

• Posterior

The Surgical and Medical Perioperative Complications of Anterior Spinal Fusion Surgery in the Thoracic and Lumbar Spine in Adults: A Review of 1223 Procedures Faciszewski, Tom MD; Winter, Robert B. MD; Lonstein, John E. MD; Denis, Francis MD; Johnson, Linda PhD Spine: July 15th, 1995 European Spine Journal March 2013, Volume 22, Supplement 1, pp 16–20| Cite as Access related complications in anterior lumbar surgery performed by spinal surgeons Authors Authors and affiliations Nasir A. QuraishiEmail authorM. KonigS. J. BookerM. ShafafyB. M. BoszczykM. P. GrevittH. MehdianJ. K. Webb Global Spine J 2016; 06(02): 147-154 DOI: 10.1055/s-0035-1557141 Georg Thieme Verlag KG Stuttgart · New York Approach-Related Complications of Anterior Lumbar Interbody Fusion: Results of a Combined Spine and Vascular Surgical Team Ralph J. Mobbs1, 2, 3, Kevin Phan1, 2, Daniel Daly3, Prashanth J. Rao1, 2, 3, Andrew Lennox1, 3, 4 The Unique Complications of Coccidioidomycosis of the Spine: A Detailed Time Line of Disease Progression and Suppression Lewicky, Yuri M. MD; Roberto, Rolando F. MD; Curtin, Stephen L. MD Spine: October 1st, 2004 - Volume 29 - Issue 19 - p E435-E441 doi: 10.1097/01.brs.0000141175.18790.fe Case Report European Spine Journal April 2015, Volume 24, Supplement 3, pp 287–313 | Cite as MIS lateral spine surgery: a systematic literature review of complications, outcomes, and economics Authors Authors and affiliations Jeff A. LehmenEmail authorEdward J. Gerber

Abdominal complications from Anterior spine Surgery

Vascular: 6.2-13.8% Viscus: 1.6-3.9% Genitourinary: 0-7.2% Abdominal wall: 1.3% Neurological: 13-75% XLIF 0-5% old school Infection: 2.2-4.3%

The Unique Complications of Coccidiodomycosis

• f the Spine: A

Detailed Time Line

• f Disease

Progression and Suppression

Lewicky, Yuri M. MD; Roberto, Rolando F. MD; Curtin, Stephen L. MD Spine: October 1st, 2004 - Volume 29 - Issue 19 - p E435-E441 Case Report

• 36 yo black female with

chronic L5-S1 Cocci

• steodiscitis with recurrent

presacral abscess

• Previous staged anterior

debridement and posterior stabilization 2 years prior and subsequent hardware removal 6 months prior

• Re-exploration and

debridement and placement of CaSO4 pellets with General/vascular surgeon

• Postop ileus, mild

distension, no pain, no change in vitals

• POD#3 has BM with

CaSO4 pellets seen in the toilet

• Perforated sigmoid

colon

• Diverting colostomy

performed

• Over the course of the

next year patient had another posterior debridement and a case

• f pericarditis
• 14 months post-op she

had colostomy take down

• Two year post-op no

pain, doing well, continues on Fluconazole 800mg/day

Personal recommendations

• Anterior approaches with

access/co-surgeon

• Working relationship with

access/co-surgeon

• Recognize hidden bleeding
• Consider all possibilities
• Re-exploration vs advanced

imaging/interventional radiology

• Working relationship with

access/co-surgeon and interventional radiologist